We evaluated the impact on progression-free survival (PFS) of achieving a deep metabolic response at 2-deoxy-2[18F] fluoro-d-glucose positron emission tomography (FDG-PET) in patients with refractory or relapsed (R/R) classic Hodgkin lymphoma (cHL) following a new salvage regimen named Bv+Bs (brentuximab vedotin + bendamustine supercharge), from 2013 to 2017. In this real-life study, 20 consecutive patients (aged <60 years) with R/R cHL after failure of ≥1 salvage treatments received Bv+Bs regimen consisting of 3-days outpatient IV infusions of 1.8 mg/kg of Bv on day 1 of each 3-week cycle combined in sequence to bendamustine on days 2 and 3 of the treatment cycle at a fixed dose of 120 mg/m2 per day, for a total of 4 courses. A robust primary prophylaxis approach, including premedication, antimicrobials, stimulating factors, and cytomegalovirus monitoring, was systematically performed. The 20 patients (all evaluable) underwent 4 courses of Bv+Bs with a median dose intensity of 100% for both Bv and Bs. Ten patients (50%) experienced grade ≥3 treatment-related adverse events, without requiring hospitalization. At post-Bv+Bs reevaluation, 80% of patients had deep metabolic responses with Deauville 5-point scale scores ≤2. Thereafter, 14 patients (70%) received autologous hematopoietic stem cell transplantation (HSCT; peripheral blood stem cells previously harvested in 12 cases), and 4 patients (10%) received allogeneic HSCT. At a median follow-up of 27 months from Bv+Bs regimen initiation, the 2-year PFS of the entire population was 93.7% (95% confidence interval, 62.7% to 99.6%). Our data suggest that Bv+Bs regimen-driven strategy may be a promising salvage option to improve long-term control of high-risk Hodgkin lymphoma.

Brentuximab vedotin followed by bendamustine supercharge for refractory or relapsed Hodgkin lymphoma / Picardi, M.; Della Pepa, R.; Giordano, C.; Pugliese, N.; Mortaruolo, C.; Trastulli, F.; Rascato, MARIA GABRIELLA; Cappuccio, Ilaria; Raimondo, M.; Memoli, M.; Monteverde, M.; Mascolo, M.; Pane, F.. - In: BLOOD ADVANCES. - ISSN 2473-9529. - 3:9(2019), pp. 1546-1552. [10.1182/bloodadvances.2019000123]

Brentuximab vedotin followed by bendamustine supercharge for refractory or relapsed Hodgkin lymphoma

Picardi M.;Della Pepa R.;Giordano C.;Pugliese N.;Mortaruolo C.;Trastulli F.;RASCATO, MARIA GABRIELLA;CAPPUCCIO, ILARIA;Raimondo M.;Memoli M.;Monteverde M.;Mascolo M.;Pane F.
2019

Abstract

We evaluated the impact on progression-free survival (PFS) of achieving a deep metabolic response at 2-deoxy-2[18F] fluoro-d-glucose positron emission tomography (FDG-PET) in patients with refractory or relapsed (R/R) classic Hodgkin lymphoma (cHL) following a new salvage regimen named Bv+Bs (brentuximab vedotin + bendamustine supercharge), from 2013 to 2017. In this real-life study, 20 consecutive patients (aged <60 years) with R/R cHL after failure of ≥1 salvage treatments received Bv+Bs regimen consisting of 3-days outpatient IV infusions of 1.8 mg/kg of Bv on day 1 of each 3-week cycle combined in sequence to bendamustine on days 2 and 3 of the treatment cycle at a fixed dose of 120 mg/m2 per day, for a total of 4 courses. A robust primary prophylaxis approach, including premedication, antimicrobials, stimulating factors, and cytomegalovirus monitoring, was systematically performed. The 20 patients (all evaluable) underwent 4 courses of Bv+Bs with a median dose intensity of 100% for both Bv and Bs. Ten patients (50%) experienced grade ≥3 treatment-related adverse events, without requiring hospitalization. At post-Bv+Bs reevaluation, 80% of patients had deep metabolic responses with Deauville 5-point scale scores ≤2. Thereafter, 14 patients (70%) received autologous hematopoietic stem cell transplantation (HSCT; peripheral blood stem cells previously harvested in 12 cases), and 4 patients (10%) received allogeneic HSCT. At a median follow-up of 27 months from Bv+Bs regimen initiation, the 2-year PFS of the entire population was 93.7% (95% confidence interval, 62.7% to 99.6%). Our data suggest that Bv+Bs regimen-driven strategy may be a promising salvage option to improve long-term control of high-risk Hodgkin lymphoma.
2019
Brentuximab vedotin followed by bendamustine supercharge for refractory or relapsed Hodgkin lymphoma / Picardi, M.; Della Pepa, R.; Giordano, C.; Pugliese, N.; Mortaruolo, C.; Trastulli, F.; Rascato, MARIA GABRIELLA; Cappuccio, Ilaria; Raimondo, M.; Memoli, M.; Monteverde, M.; Mascolo, M.; Pane, F.. - In: BLOOD ADVANCES. - ISSN 2473-9529. - 3:9(2019), pp. 1546-1552. [10.1182/bloodadvances.2019000123]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/775591
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